A Multicenter Trial of PLA vs. Surgery for Treating PTMC

NCT ID: NCT03377829

Last Updated: 2021-03-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-01

Study Completion Date

2022-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a multicenter prospective controlled trial of percutaneous laser ablation(PLA) versus conventional surgery for the treatment of papillary thyroid microcarcinoma (PTMC).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

PLA is the acronym for "Percutaneous Laser Ablation". The treatment consists in the destruction (ablation) of Papillary Thyroid Micro Carcinoma by means of optical fibers that deliver high-energy light (laser) into the lesion through skin puncturing (percutaneous). The procedure is performed under ultrasound imaging guidance (ultrasound-guided). The destruction of the lesion occurs through overheating and coagulation. PLA, however, still needs a large-scale validation trial in order to be considered as an effective alternative to both surgery or follow-up for low-risk PTMC in elderly patients and/or in patients with co-morbidities that might expose the patients to a high surgical risk.

After a comprehensive information, patients will be consecutively assigned to Group 1 (surgery, preferentially lobectomy) or to Group 2 (percutaneous laser ablation, performed according to the attached procedure).Peri and post-operative complications, need of drug treatment, length of hospital admission and customer satisfaction will be registered.

The aims of this study are as follows: 1.To establish the rate of cure or partial ablation; 2.To compare the complication rate, time expenditure and costs of two procedures; 3.To assess changes in thyroid function and the need of substitution therapy with two procedures; 4.To assess the tolerability of the procedure, the customer satisfaction and the impact on the quality of life of the patients between conventional surgery and PLA.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Thyroid Cancer Treatment Related Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Percutaneous laser ablation(PLA)

Eligible participants with PTMC will be randomly assigned to this group and undergo percutaneous laser ablation(PLA). All the process is under the detection of real-time ultrasound.After surgery, all the patients will accept contrast-enhanced ultrasound(CEUS), regular ultrasound follow-up, thyroid functional detection, fine-needle aspiration biopsy(FNAB), neck CT.Per and post-operative complications, need of drug treatment, length of hospital admission and customer satisfaction will be registered.

Group Type EXPERIMENTAL

PLA

Intervention Type PROCEDURE

During the PLA, the patient is in supine position with head extended: the physician, ultrasound assistant and trained nurse work within the sterile field. Under constant ultrasound image guidance and after local anesthesia by means of 2% xylocaine infiltration, thin needles (21G) are positioned in the thyroid lesion, within safety distance from the surrounding anatomical structures. A plane-cut tip fiber optics is inserted into the PTMC through the needle. The laser at 1064 nm wavelength is turned on for 10 minutes until the pre-established energy dose is attained. There is usually no pain or very limited pain.

Surgery

Eligible participants with PTMC will be randomly assigned to this group and undergo total/subtotal thyroid surgery.

Group Type ACTIVE_COMPARATOR

Thyroid Surgery

Intervention Type PROCEDURE

Patients are routinely disinfected and spread the drapes after general anesthesia. Neck skin, fat, placenta muscle are incised successively. The flap is separated to the upper edge of thyroid cartilage, neck white line is incised and anterior muscle group is separated. Then both sides thyroid lobes are exposed. Cut off the isthmus, ligature the thyroid artery, cut off the upper pole. Ligature and cut off the ipsilateral thyroid vein. Reveal and protect the ipsilateral recurrent laryngeal nerve and the parathyroid gland during the entire process. Finally patient is performed total thyroidectomy or subtotal thyroidectomy.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

PLA

During the PLA, the patient is in supine position with head extended: the physician, ultrasound assistant and trained nurse work within the sterile field. Under constant ultrasound image guidance and after local anesthesia by means of 2% xylocaine infiltration, thin needles (21G) are positioned in the thyroid lesion, within safety distance from the surrounding anatomical structures. A plane-cut tip fiber optics is inserted into the PTMC through the needle. The laser at 1064 nm wavelength is turned on for 10 minutes until the pre-established energy dose is attained. There is usually no pain or very limited pain.

Intervention Type PROCEDURE

Thyroid Surgery

Patients are routinely disinfected and spread the drapes after general anesthesia. Neck skin, fat, placenta muscle are incised successively. The flap is separated to the upper edge of thyroid cartilage, neck white line is incised and anterior muscle group is separated. Then both sides thyroid lobes are exposed. Cut off the isthmus, ligature the thyroid artery, cut off the upper pole. Ligature and cut off the ipsilateral thyroid vein. Reveal and protect the ipsilateral recurrent laryngeal nerve and the parathyroid gland during the entire process. Finally patient is performed total thyroidectomy or subtotal thyroidectomy.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Newly diagnosed PTMC (maximun diameter\> = 5 mm and \< = 10 mm) proved by fine needle aspiration biopsy with good thyroid function;
* Age≥ 18 Y;
* Single nodule without thyroid capsule contact;
* There had more than 3mm distance between nodules and trachea, carotid artery, recurrent laryngeal nerve (The distance should up to 5mm after injection of isolation fluid);
* No coarse calcification or eggshell-like calcification;
* Imaging examination without local or distant metastasis;
* Without chemotherapy, radiotherapy and other related therapies;
* A complete clinical, pathological and follow-up information;
* Get informed consent signed by the patient or family member.

Exclusion Criteria

* Multifocal PTMC;
* Combined with other types of thyroid cancer or hyperthyroidism;
* Lesion contact with thyroid capsule or located in the isthmus;
* Serious coagulation dysfunction;
* Contralateral vocal cord paralysis;
* Imaging examination with local or distant metastasis;
* Active Tuberculosis and HIV-positive patients;
* Patients can not understand or follow research protocol;
* Pregnant woman.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

WeiWei Zhan

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

WeiWei Zhan

Director, Head of Ultrasound Department; Clinical Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

WeiWei Zhan, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Ruijin Hospital, affiliated to Medical School of Shanghai Jiaotong University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Ultrasound Department, Chinese PLA General Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Ultrasound Department of the Third Hospital Affiliated to Zhongshan University

Guangzhou, Guangdong, China

Site Status RECRUITING

Ultrasound Department, the Second Affiliated Hospital of Harbin Medical Univercity

Harbin, Heilongjiang, China

Site Status RECRUITING

Ultrasound Department, the Xiangya Third Hospital of Zhongnan University

Changsha, Hunan, China

Site Status RECRUITING

Ultrasound Department, the First Affliction Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status RECRUITING

Ultrasound Department, the First Affiliated Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status RECRUITING

Ultrasound Department, First people's Hospital Affiliated to Medical School of Shanghai Jiaotong University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Ultrasound Department, Ruijin Hospital Affiliated to Medical School of Shanghai Jiaotong University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

The department of ultrasound ,second affiliated hospital of xi'an jiaotong university

Xi’an, Shanxi, China

Site Status RECRUITING

Department of Ultrasonography, Zhejiang Cancer Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

Department of Ultrasound Medicine, the First Hospital Affiliated to Medical School of Zhejiang University

Hangzhou, Zhejiang, China

Site Status RECRUITING

Department of Endocrinology, Regina Apostolorum Hospital

Rome, , Italy

Site Status RECRUITING

Diagnostic Imaging, Regina Apostolorum Hospital

Rome, , Italy

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

China Italy

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Lu Zhang

Role: CONTACT

+8615021590551

Wei Zhou

Role: CONTACT

+8613681642667

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Ming-bo Zhang

Role: primary

+8613552744805

Fang Xie

Role: backup

+8613717981887

Tao Wu

Role: primary

+8613560332786

Jie Ren

Role: backup

+8613925155583

Shuang-quan Jiang

Role: primary

+8613704800486

Guo-qing Du

Role: backup

+8615945164997

Wen-gang Liu

Role: primary

+8615116342563

Ping Zhou

Role: backup

+8613974809881

Hong-yan Deng

Role: primary

+8618262637897

Jing Hang

Role: backup

+8613951827096

Xiao-feng Wu

Role: primary

+8618510516168

Feng-lin Dong

Role: backup

+8613771978973

Qiu-sheng Shi

Role: primary

+8613311986321

Lian-fang Du

Role: backup

+8613386259562

Lu Zhang

Role: primary

+8615021590551

Wei Zhou

Role: backup

+8613681642667

Wan-ying Jia

Role: primary

+8615529619387

Jue Jiang

Role: backup

+8618066736699

Dong Xu

Role: primary

+86057188122255

Li-ping Wang

Role: backup

+85057188122252

Qi-yu Zhao

Role: primary

+8613819140217

Enrico Papini

Role: primary

Giancarlo Bizzarri

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

1001253709008902933

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.